Removal of grade IV vestibular schwannomas by retrosigmoid approach: results of a cumulative series of two European centers

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F44555601%3A13450%2F23%3A43898620" target="_blank" >RIV/44555601:13450/23:43898620 - isvavai.cz</a>

Result on the web

<a href="https://www.tandfonline.com/doi/full/10.1080/02688697.2023.2244581" target="_blank" >https://www.tandfonline.com/doi/full/10.1080/02688697.2023.2244581</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1080/02688697.2023.2244581" target="_blank" >10.1080/02688697.2023.2244581</a>

Result language

angličtina

Original language name

Removal of grade IV vestibular schwannomas by retrosigmoid approach: results of a cumulative series of two European centers

Original language description

IntroductionThe aim of our study was to study the association between end-of-surgery facial nerve stimulation threshold and extent of tumor resection in case of grade IV vestibular schwannomas.Materials and methodsGrade IV VSs represent a surgical challenge as a risk/benefit ratio must be considered in balancing a satisfactory extent of resection against a good postoperative functional outcome. We reviewed a cumulative series of 57 patients with large/giant VSs who were operated on by retrosigmoid approach in the period from 2008 to 2018 in two European centers, namely San Filippo Neri Hospital, Rome, Italy and Masaryk Hospital, Usti nad Labem, Czech Republic. Extent of resection, intraoperative direct electrical stimulation threshold of facial nerve and postoperative facial outcome were examined.ResultsTotal or near-total resection was accomplished in 40 (75.5%) cases. Two groups were compared: total or near-total resection (T + NT) and subtotal resection (ST); the end-of-surgery facial nerve stimulation threshold significantly differed (T + NT: 0.24 mA, ST: 0.44 mA, p = 0.036). A critical cutoff was found at 0.2mA; values similar or inferior to this correctly predicted total or near-total resection in 86.7% of cases. Thirty (56.6%) patients had a normal postoperative facial outcome (HB1). Among the 40 patients in T + NT group, 32 (80%) retained an acceptable facial function (HB1-2).ConclusionsLower facial nerve stimulation thresholds positively predict a broader extent of resection and total or -near total resection should be accomplished in such cases. Judicious (subtotal) resection is preferred if threshold values increase while dissecting firmly adherent tumors.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30210 - Clinical neurology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

British Journal of Neurosurgery

ISSN

0268-8697

e-ISSN

1360-046X

Volume of the periodical

neuveden

Issue of the periodical within the volume

neuveden

Country of publishing house

GB - UNITED KINGDOM

Number of pages

2

Pages from-to

"nestrankovano"

UT code for WoS article

001049752900001

EID of the result in the Scopus database

2-s2.0-85168269479